|
<br />Date Received
<br />
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />/!Jlllc/O '\
<br />Phonkontact for-Permitting
<br />
<br />Fax-813-780-0021
<br />
<br />8113-780-0020
<br />
<br />...1111.111
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />3 -r'l?~OO a-O
<br />Owner Phone Number I ~ /3 - ~ 9 c- 303 j/ ~
<br />Owner Phone Number I I
<br />I
<br />I
<br />I
<br />
<br />LOT #
<br />
<br />Owner's Name
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />6S'(3~ J ~ tfl, d.
<br />
<br />WORK PROPOSED
<br />
<br />y-rhy Jell ()l s
<br />
<br />I PARCEL ID#I \ \ - '2..(P - 2 \ - DO \ 0 -6 3~6b -GllO
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />E3 NEW CONSTR rx:J. ADD/AL T D SIGN D MOVE D
<br />INSTALL D REPAIR
<br />PROPOSED USE ~ SFR D COMM D OTHER
<br />TYPE OF CONSTRUCTION CXI BLOCK D FRAME D STEEL D
<br />
<br />/ILu) I!JJ1t,dlc E'SftA.JL#-/~
<br />
<br />BUILDING SIZE I SQ FOOTAGE I HEIGHT I
<br />1111111111111111111111111111111111111111I11111111111111111111111""1'11'1"1'11111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />
<br />DESCRIPTION OF WORK
<br />
<br />D BUILDING 1$ :J/nJ I
<br />D ELECTRICAL 1$ I
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I
<br />D GAS D ROOFING D
<br />FINISHED FLOOR ELEVATIONS I I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY D OTHER
<br />FLOOD ZONE AREA DYES
<br />
<br />DNO
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />
<br />
<br />
<br />"
<br />COMPANY
<br />REGISTERED
<br />
<br />flOf?7~ C.N-Jn<: y
<br />I Y / N I FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br />Y / N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br /> License #
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />111111I1111I1111111111111111111111I1111II111111111I1111I111111II1111I1111111111111111111111111111111111111111111111111111111111111
<br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivlsions/large projects
<br />Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction.
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
<br />Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />
<br />DI~~~tj~~~': ' , , , , , . , , , . , , , . , . , , , . . , , , . . . . , . , , , , , , , , , , . , . , , , . . , , , , . , , , , . . . , , , , . , , , , , , , , . . . . , . . . , . , , . . . , . . , , , , , , . , . . . , . . , , , . , . . . , . . , , , , , , , , . , , , . , . , , ,
<br />
<br />Fill out application completely.
<br />Owner & Contractor sign back of application, notarized
<br />If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000)
<br />
<br />Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage)
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
|